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10/08/2024 | Press release | Distributed by Public on 10/08/2024 15:38

9 Tadalafil (Cialis) Interactions You Should Know About

By age 50, as many as5 out of 10 menexperienceerectile dysfunction(ED). For some,tadalafil(Cialis) may be a preferred medication to get or maintain an erection. Why? Because tadalafillasts longerthan other similar medications. And many men may take tadalafil forbenign prostatic hyperplasia(enlarged prostate), too.

However,high blood pressureandheart diseaseare also more common as men get older. And medications used to treat them caninteract withtadalafil. Some interactions can have dangerous effects and should be avoided altogether. Others just require monitoring.

Some peopletake tadalafil daily, while others only take it as needed. And one dose canstick around in your bodyfor several days. This can result in interactions - even if you didn't take tadalafil and another medication on the same day.


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See all tadalafil cialis pricesYour regular prescriber or a telehealth service, may have prescribed tadalafil for your ED. In any case, it's important to know abouttadalafil interactions. Providing your healthcare team with your currentmedication listcan help manage them in advance.

1. Nitrates

Nitratesare used to treat and prevent angina (chest pain) caused by heart disease. Examples include nitroglycerin (Nitrostat), isosorbide mononitrate (Monoket), and isosorbide dinitrate (Isordil).

Phosphodiesterase 5 (PDE5) inhibitors, like tadalafil, arecontraindicatedwith nitrates. This means the combination should be avoided since it can cause harm. Taking these medications together can result in a severe drop in blood pressure (calledhypotension). This can make you feel dizzy and possibly cause you to faint or pass out.

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2. Alpha blockers

Alpha blockersare a medication class used to treat high blood pressure. Some are also used to help withurinary symptomsfrom BPH. Examples include terazosin (Hytrin),tamsulosin, (Flomax), and doxazosin (Cardura). Alpha blockers can cause your blood vessels to widen. This can result in a decrease in your blood pressure.

Tadalafil also causes your blood vessels to widen. So taking an alpha blocker with tadalafil can significantly reduce your blood pressure. This can cause dizziness and fainting in some people. To be safe, your prescriber may have you start with alower Cialis dosefor ED if you're taking an alpha blocker.

3. Blood pressure medications

It's common to take a blood pressure medication, such as lisinopril, with tadalafil. That's because having high blood pressure can be acontributing factorfor ED. What's more, some blood pressure medications can alsocause ED.

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There are severaltypes of medicationsavailable to lower your blood pressure if it's too high. And they all work differently to achieve this effect. Examples includediuretics(water pills), angiotensin-converting enzyme(ACE) inhibitors, andcalcium channel blockers. When they're taken with tadalafil, some people experience a small drop in blood pressure.

This interaction may not cause meaningful blood pressure changes for everyone. But it's still important to use caution with this combination. Tell your prescriber if you experience symptoms such as dizziness or lightheadedness.

4. sGC stimulators

Riociguat (Adempas) is used to managepulmonary arterial hypertension(high blood pressure in the lungs). And vericiguat (Veroquvo) is used in certain types of heart failure. Both medications aresoluble guanylate cyclase (sGC) stimulators. They work by relaxing blood vessels to improve blood flow.

Like nitrates, these medications should not be taken with tadalafil. That's because your blood pressure could drop dangerously low with this combination.

5. PDE5 inhibitors like Viagra

As discussed earlier, tadalafil is a PDE5 inhibitor.Other common examplesof this class includesildenafil(Viagra, Revatio) and vardenafil (Levitra).

For most people, taking more than one PDE-5 inhibitor may not provide an added benefit. Instead, you may be more likely to experience side effects, like dizziness, headache, and flushing.

Your prescribermay recommendtaking two PDE-5 inhibitors in certain situations. For example, they may have you takeCialis every day and Viagra as needed. But you should always check with them before taking more than one of these medications at the same time.

6. Protease inhibitors

Protease inhibitorsare medications used to treat viral infections such ashepatitis CandHIV. Examples includeritonavir(Norvir), darunavir (Prezista), and atazanavir (Reyataz). Sometimes they're combined with medications to help them work better. One example of this isPaxlovid(nirmatrelvir / ritonavir) for COVID-19.

Ritonavir has been shown to increase the blood levels of tadalafil when taken together. Other protease inhibitors may have a similar interaction. This can increase the risk of side effects like vision changes, low blood pressure, and prolonged erections.

Your prescriber may limit your tadalafil dosage with this combination. This may depend on whether you're taking tadalafil every day or as needed.

7. Anti-infective medications

Certain anti-infective medications, including antibiotics and antifungals, interact with many medications. Examples of these include erythromycin (Ery-Tab), ketoconazole, and itraconazole (Sporonax).

Similar to protease inhibitors, these medications may increase tadalafil levels in the blood. This may result in dizziness and fainting. Your tadalafil dosage may need to be adjusted if you're also taking one of these medications.

8. Grapefruit

You've probably heard that grapefruit caninteract with medications. And tadalafil - as well as other PDE5 inhibitors - is no exception. For some people, this combination may cause a drop in blood pressure. But this can vary by person.

Is consuming grapefruit or grapefruit juice part of your regular routine? If so, ask your prescriber or pharmacist about how much is safe with your medications.

9. Alcohol

Both tadalafil and alcohol can cause your blood vessels to relax. When you combine the two, this effect can cause your blood pressure to drop. This may be more apparent whenchanging positions(like from sitting to standing). You may feel dizzy and be more likely to fall.

Because of this, it's best tominimize or avoid alcoholwhile taking tadalafil. And if you're taking tadalafil for ED, alcoholisn't going todo you any favors. Talk to your prescriber about how much alcohol is safe for you to drink.

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Tadalafil (Cialis) can interact with other medications, foods, and beverages. Examples include nitrates, alpha blockers, and alcohol. Grapefruit, blood pressure medications, and Paxlovid (nirmatrelvir / ritonavir) can also interact with tadalafil. Some interactions should be avoided, such as nitrates. Others can be managed with dosage changes and monitoring.

Make sure your prescriber and pharmacist have your current medication list. They can review it to determine which interactions may affect you and how to manage them.